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对于压力性尿失禁女性患者,度洛西汀治疗是否存在预测参数?

Do predictive parameters exist for therapy with duloxetine in women with stress urinary incontinence?

作者信息

Schwertner-Tiepelmann Nadine, Schwab Frank, Tunn Ralf

机构信息

Department of Urogynecology, German Pelvic Floor Center, St. Hedwig Hospital, Grosse Hamburger Strasse 5-11, 10115, Berlin, Germany,

出版信息

Int Urogynecol J. 2014 Aug;25(8):1071-9. doi: 10.1007/s00192-014-2358-1. Epub 2014 Mar 7.

Abstract

INTRODUCTION AND HYPOTHESIS

To determine whether predictive parameters exist for successful duloxetine therapy in women with stress urinary incontinence (SUI).

METHODS

Secondary analysis was performed of 1,714 women who received duloxetine in the Stress Urinary Incontinence Treatment (SUIT) study, a 12-month longitudinal observational study to evaluate the results and direct costs of SUI treatment. Data of 1,087 women were analyzed. Univariate and multivariate analyses (stepwise forward logistic regression) were performed to investigate factors for discontinuation of treatment.

RESULTS

Parameters that significantly reduced the probability of treatment termination were smoking and a body mass index (BMI) <20, while obesity (BMI >30) increased the probability in the univariate analysis. In the multivariate analysis significantly reduced likelihoods of duloxetine treatment discontinuation were found for an age >65 years, country, and 7 to 13 incontinence episodes per week. Co-medication, particularly anti-cholinergics, was significantly associated with therapy termination. Previous SUI surgery had no effect.

CONCLUSIONS

Identification of predictive parameters for successful therapy with duloxetine in women with SUI is desirable, and co-medications should be critically considered.

摘要

引言与假设

确定压力性尿失禁(SUI)女性患者中是否存在度洛西汀治疗成功的预测参数。

方法

对1714名在压力性尿失禁治疗(SUIT)研究中接受度洛西汀治疗的女性进行二次分析,该研究是一项为期12个月的纵向观察性研究,旨在评估SUI治疗的结果和直接成本。分析了1087名女性的数据。进行单因素和多因素分析(逐步向前逻辑回归)以研究治疗中断的因素。

结果

显著降低治疗终止概率的参数是吸烟和体重指数(BMI)<20,而在单因素分析中肥胖(BMI>30)增加了治疗终止的概率。在多因素分析中,发现年龄>65岁、国家以及每周有7至13次尿失禁发作显著降低了度洛西汀治疗中断的可能性。联合用药,尤其是抗胆碱能药物,与治疗终止显著相关。既往SUI手术无影响。

结论

确定SUI女性患者度洛西汀治疗成功的预测参数很有必要,并且应谨慎考虑联合用药。

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